Patient care ‘undermined’ as exhausted NHS Lothian nurses face burnout crisis
.jpg?width=96&crop=1:1,smart)
Nurses and midwives in NHS Lothian are being “ground down by a vicious cycle” as figures show almost 400,000 nursing and midwifery hours were lost to mental health-related sickness in 2025/26
Patient care across NHS Lothian is being undermined by a "vicious cycle" of nurse burnout, excessive workloads and staff shortages, a union has warned.
The Royal College of Nursing (RCN) Scotland said severe workplace pressures are driving exhausted staff to long-term sickness, threatening the delivery of safe and effective care at NHS Lothian.
It comes as Freedom of Information figures reveal the devastating toll the crisis is taking on frontline workers, with nearly 400,000 nursing and midwifery hours lost to mental health-related sickness last year.
Ricky Sherriff-Short, Senior Officer at Royal College of Nursing Scotland, commented: “Nursing staff are being ground down by a vicious cycle of increasing workload pressures and more and more gaps in the workforce. Not getting breaks, excessive workloads and high vacancy rates are major factors in mental health-related sickness absence rates amongst nursing staff.”
Nursing staff are trapped in a cycle compounded by the “negative effects of a stubborn vacancy rate,” according to Mr Sherriff-Short. He highlighted that more than a quarter of nurses in Scotland self-reported as being at high risk of burnout.
He said: “The more often they work on a day with colleagues missing from the shift, the greater the danger of burnout. The NMC has reported that 27% of nurses working in Scotland are at high risk of burnout, and 29.8% are struggling to cope with workload.”
In 2025, the RCN made a series of recommendations to the Scottish Government as part of its Nursing Workforce in Scotland 2025 report. It recommended including increased predicted absence levels in workforce planning calculations.
And that the calculations of the number of nursing staff needed must include time for breaks and recognise the allocation of protected time for learning, realistic rates of sickness absence. It also recommended including a reduction in the working week to 36 hours from April 2026.
Figures show that the average length of episodes of mental health-related absence has increased by almost 50% since 2023/24 from 141 days to 211 days. Over the three year period covered by the data, more than one-million nursing and midwifery hours have been lost.
In 2024, NHS Lothian launched its wellbeing strategy, Work Well 2024-2027. It was designed as an “enabling strategy… that will improve staff wellbeing and experience”.
The strategy states that since May 2023, hours lost to ‘Anxiety/ Stress/Depression/Other Psychiatric Illnesses’ accounts for nearly three times the second most significant contributor.
In August 2025, the NHS Lothian Board said that a low university intake for first year nursing in the current year was anticipated to cause further workforce challenges in three years’ time.
Mr Sherriff-Short said that gaps in the workforce “undermines safe and effective care”.
He continued: ”Safe nurse staffing saves lives, protects exhausted staff and strengthens health and care services. Safe staffing is also vital for improving retention of experienced nurses and attracting new individuals into the profession. Both are key for securing a sustainable nursing workforce able to meet the increasing needs of Scotland’s ageing population.”
Alison Macdonald, Executive Nurse Director, NHS Lothian, said: “The hours attributed to mental health-related sickness absence are approximately 1.85% of the annual contracted hours worked by our nursing and midwifery staff. While the overall number of hours is significant, it represents absences across a nursing and midwifery workforce of more than 11,000 full-time equivalent staff.
“We have continued to strengthen the nursing and midwifery workforce in NHS Lothian, reducing our vacancy rates from 3.43% in April 2025 to 2.06% in April 2026.
“We take staff wellbeing seriously, and have a range of measures in place to support our teams, from ongoing recruitment campaigns to investment in wellbeing initiatives.”